Dry Eye After Small Incision Lenticule Extraction and Femtosecond Laser-Assisted LASIK: Meta-Analysis
Dry Eye After Small Incision Lenticule Extraction and Femtosecond Laser-Assisted LASIK: Meta-Analysis
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DOI：
10.1097/ico.0000000000000999
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发表时间：
2017-01-01
期刊：
影响因子：
2.8
通讯作者：
Shimizu, Kimiya
中科院分区：
文献类型：
--
作者：
Kobashi, Hidenaga;Kamiya, Kazutaka;Shimizu, Kimiya
目的：比较小切口角膜基质透镜摘除术（SMILE）和飞秒激光辅助激光原位角膜磨镶术（FS-LASIK）术后眼表完整性和神经支配情况。方法：检索 Cochrane 对照试验中心注册库、PubMED 和 EMBASE 进行前瞻性比较研究。符合选择标准的试验进行了质量评价，数据由 2 位独立作者提取。使用加权平均差 (WMD) 和 95% 置信区间 (CI) 来比较干眼检查和角膜基底神经密度 (SMILE-FS-LASIK)。 结果：该研究涵盖 5 项试验。两组之间的 Schirmer 测试评分没有发现显着差异（WMD = -1.91 和 0.27；95% CI，-5.02 至 1.20 和 -0.99 至 1.54；1 个月和 6 个月随访时 P = 0.23 和 0.67）。 SMILE 组的泪膜破裂时间显着超过 FS-LASIK 组（WMD = 0.65 和 1.14；95% CI，0.20-1.10 和 0.18-2.10；1 个月和 6 个月随访时，P = 0.004 和 0.02）。术后 6 个月，SMILE 组的眼表疾病指数评分明显更好（WMD = -10.12，95% CI，-16.07 至 -4.18，P = 0.0008）。两组之间泪液渗透压没有显着差异（WMD = -5.19 和 -6.37；95% CI，-17.15 至 6.76 和 -22.74 至 10.00；1 个月和 6 个月随访时分别 P = 0.39 和 0.45）。术后 1 个月和 6 个月，SMILE 组观察到较高的角膜敏感性（WMD = 11.35 和 3.49；95% CI，7.29-15.40 和 1.76-5.21；P < 0.00001 和
Purpose: To compare postoperative ocular surface integrity and innervation between small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK).Methods: The Cochrane Central Register of Controlled Trials, PubMED, and EMBASE were searched for prospective comparative studies. Trials meeting the selection criteria were quality appraised, and the data were extracted by 2 independent authors. The weighted mean differences (WMDs) and 95% confidence intervals (CIs) were used to compare dry eye examinations and corneal subbasal nerve density (SMILE-FS-LASIK).Results: The study covered 5 trials. No significant difference was found in the Schirmer test score between both groups (WMD = -1.91 and 0.27; 95% CI, -5.02 to 1.20 and -0.99 to 1.54; P = 0.23 and 0.67 at 1- and 6-month follow-ups, respectively). Tear breakup time in the SMILE group significantly exceeded that in the FS-LASIK group (WMD = 0.65 and 1.14; 95% CI, 0.20-1.10 and 0.18-2.10; P = 0.004 and 0.02, at 1- and 6-month follow-ups, respectively). Ocular surface disease index scores were significantly better in the SMILE group 6 months postoperatively (WMD = -10.12, 95% CI, -16.07 to -4.18, P = 0.0008). No significant difference was found in tear osmolarity between both groups (WMD = -5.19 and -6.37; 95% CI, -17.15 to 6.76 and -22.74 to 10.00; P = 0.39 and 0.45 at 1- and 6-month follow-ups, respectively). Higher corneal sensitivity was observed in the SMILE group 1 and 6 months postoperatively (WMD = 11.35 and 3.49; 95% CI, 7.29-15.40 and 1.76-5.21; P < 0.00001 and